Evolution keeping pace…. NO!

I was having a conversation with my students this week as we discussed the fact that the maternal age of the first child has significantly increased in the last 30 years as social expectations change. Indeed the average age that women had their first child in the 1970s was 23 years old. In this decade the average age is 30 years old. Seven years may not seem a long time but in reproductive terms this is a huge difference. The fertility of a 30 year old women is significantly lower than that of a 23 year old. This is because a women is born with all of her eggs, so as she ages so do her eggs and the genetic material within them. This is why infertility and miscarriage rates increase as women age.

One of my students commented that perhaps we will/are evolving to take account of our changing requirements from our reproductively biology. It was my sad duty to inform her that we are certainly NOT. Evolution takes place over the course of hundreds of thousands of years and the last 100 years are a mere blink of an eye in evolutionary terms. We evolve so slowly due to our life span and the relatively low number of offspring we have. Indeed our bodies and biology have not evolved much past the era of cavemen. It may surprise you to know that if we were to go back in time and meet our cavemen ancestors they, would be indistinguishable from modern day man. Our biology is just not designed for pregnancy.

This is why it is important when you are trying to conceive in your 30’s not to leave it too long before you consider checking your fertility. Statistically 89% of couples with no underlying fertility problems will conceive in the first year of trying. Male fertility testing is a good place to start, as half of all fertility problems are due to low sperm counts and abnormal semen parameters.

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Don’t Use Anabolic Steroids

The use of anabolic steroids has become one of the main causes of preventable male factor infertility.  Increasing numbers of men, including teenagers, are now taking these steroids. They are sourced in the locker rooms, primarily gyms, to help build up muscle bulk in a bid to make themselves look more “manly”.

However, most are unaware of the side effects from these illegal drugs. They pose significant risks to their long term health, and more specifically their future fertility and sperm count.  A lot of men believe they can reverse these effects with more hormones such as HMG, but this is not the case. These steroids can cause the testicles to shrink, stopping sperm production. This means that men taking anabolic steroids, and other drugs like them, may have problems starting or adding to their family in the future.

The science behind this is well known: The anabolic steroids increase testosterone production within the body. This helps build up muscle bulk.  However, this also blocks the production of testosterone in the testicles themselves, which is a necessary ingredient for sperm production.

If used for long enough and in high enough doses, the damage to male fertility can become permanent.  In some case, it may take up to a year for sperm production to return to normal after having stopped taking the anabolic steroids.

We are seeing an increasing number of men at the clinic who simply aren’t aware of the damage that taking anabolic steroids can do to their long-term health and fertility. If you have taken steroids either recently or even years ago, we advise that you get a semen analysis done to understand if your fertility has been affected.

If you are trying to start a family, now or wish to in the future, it is imperative that you look after your health. This means not taking off prescription drugs or “herbal” remedies of any sort without first consulting an expert. Eat well, exercise regularly and look after yourself.

Claire Mooney

Consultant Embryoligist

Hope Restored

My husband, Shaun, and I attempted natural conception for two frustrating years, coping with the stress, disappointment and feelings of inadequacy that inevitably set in. 

I endured endless, invasive tests – on one occasion contracting an infection that hospitalised me for two days – until we were advised that our problem lay in my husband’s low sperm count.

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Should primary microsurgical ligation of varicocele be the gold standard approach?

Abstract

Introduction: Varicocele is a common condition affecting over one in 10 men, and in cases with abnormal semen parameters, varicocele is present in about one in four men. Several methods have been used to treat this condition, of which microsurgical treatment has the lowest failure and complication rates. We present a single-centre UK series of microsurgical repair of varicocele.

Continue reading “Should primary microsurgical ligation of varicocele be the gold standard approach?”

THE PLACE OF SPERM DNA FRAGMENTATION TESTING IN CURRENT DAY FERTILITY MANAGEMENT

Abstract

In this debate article, I am going to set out the case that sperm DNA fragmentation testing is essential in current day fertility management because:

  • Our current semen analysis testing is unfit for purpose
  • We need to take a fresh look at the ‘evidence’ against sperm DNA testing
  • Sperm DNA damage testing has strong associations with every fertility check point
  • Sperm DNA damage testing has strong associations with miscarriage
  • Sperm DNA testing can explain ‘unexplained’ infertility
  • There are reasons why sperm with poor DNA are successful in ICSI
  • There are no non-invasive sperm function tests that provide the same information.
  • We need to take a fresh look at the ‘evidence’ against sperm DNA testing

We have no reason to wait. There are benefits for clinics and couples alike.

Continue reading “THE PLACE OF SPERM DNA FRAGMENTATION TESTING IN CURRENT DAY FERTILITY MANAGEMENT”

For 40 per cent of couples who can’t conceive, the problem lies with the man. So why is male infertility rarely spoken about?

Female fertility is a hot topic. Women are constantly reminded of their biological clocks and warned about the risks to fertility of diet, alcohol and stress, but there is a gradual dawning that men, too, should plan their families sooner rather than later.

Continue reading “For 40 per cent of couples who can’t conceive, the problem lies with the man. So why is male infertility rarely spoken about?”